Intracranial Abscess from Acute Sinusitis without Craniotomy

Objective: To evaluate the success of treatment of intracranial abscess occurring from acute sinus disease without utilizing craniotomy. Method: Retrospective chart review based at a tertiarty care children’s medical center. Children were evaluated from 1995 to 2010 with intracranial abscess formation from acute sinusitis. The main outcome measures were treatment modalities for acute intracranial and sinus disease. Results: Twenty-five children were evaluated from 1995 to 2010 with acute sinusitis resulting in brain abscesses. Over the first 10 years, 15 were treated successfully with an intracranial procedure and sinus surgery. Over the past 5 years, 10 cases of intracranial abscess were encountered, with 5 out of 10 treated successfully without the need for craniotomy. 4 out of 5 had small epidural abscesses treated with endoscopic sinus surgery and intravenous antibiotic, and 1 out of 5 had a small epidural and subdural abscess treated with medical therapy alone. Conclusion: Medical management of intracranial abscess along with medical or surgical treatment of acute sinusitis may be a viable option for certain children with small epidural abscesses caused by acute sinusitis.